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The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
Natural history of anastomotic leakage after elective stoma closure
K Allart1, C Sabbagh1, M Demouron1
1Department of Digestive Surgery, Amiens University Medical Center, 80054 Amiens, France; UR7518 SSPC (Simplifications of Complex Surgical Patient Care), Clinical Research Unit, Jules Verne University of Picardy, 80054 Amiens, France.
Introduction:
Elective stoma closure (ESC) is a common procedure. The main complication of ESC is anastomotic leakage, which can be revealed by peritonitis or an enterocutaneous fistula (ECF). The objective of the present study was to describe the natural history of AL after ESC.
Patients And Methods:
Between January 2015 and March 2020, all patients having undergone AL after loop or double-barreled ESC were included in a retrospective, single-center study. The rate of ECF and peritonitis at presentation, the success rate of a conservative treatment and the factors associated with the success of healing of ECF were evaluated.
Results:
From January 2015 to March 2020, 619 patients underwent a loop or double-barreled ESC in our department. The AL rate was 6.3% (n=39). The leakage was revealed by an ECF in 72% of cases (n=28). The mean±standard deviation time between the stoma closure and the diagnosis of the AL was 6±4 days. Conservative treatment was successful in 24 (85%) of the 28 patients with ECF, with a mean±SD time to recovery of 6.6±9.4 months. In a univariate analysis, none of the conservative treatments was significantly associated with healing of the ECF.
Conclusion:
AL is not rare and is mainly revealed by an ECF. Although the fistula heals in most cases, both the surgeon and the patient must be aware that the time to recovery is long.
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